Organization
FIRST IMPRESSIONS DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATT COLE DDS (OWNER)
(405) 879-0000
Entity
Organization
Contact information
Practice address
4301 NW 63RD ST, 300, OKLAHOMA CITY, OK 73116-1549
(405) 879-0000
(405) 879-0656
Mailing address
4301 NW 63RD ST, 300, OKLAHOMA CITY, OK 73116-1549
(405) 879-0000
(405) 879-0656
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6061
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200231440 A
—
OK
Enumeration date
07/31/2013
Last updated
07/31/2013
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